From the Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Denmark.
N. Tanha, MD, Research fellow, Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital; R.B. Hansen, MD, Research Fellow, Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital; C.T. Nielsen, MD, PhD, Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital; M. Faurschou, MD, PhD, Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital; S. Jacobsen, MD, Professor, Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital.
J Rheumatol. 2018 Jul;45(7):934-941. doi: 10.3899/jrheum.170933. Epub 2018 Apr 15.
In a longitudinal cohort study, we investigated whether clinical and serological manifestations at the time of classification of systemic lupus erythematosus (SLE) were predictive of subsequent development of incident proteinuria as a biomarker of incident lupus nephritis.
Patients fulfilling SLE classification criteria but having no proteinuria prior to or at the time of classification were included. Data on SLE manifestations, vital status, criteria-related autoantibodies, and SLE-associated medications were collected during clinical visits and supplemented by chart review. HR were calculated by Cox regression analyses.
Out of 850 patients with SLE, 604 had not developed proteinuria at the time of SLE classification. Of these 604 patients, 184 (30%) developed incident proteinuria following SLE classification. The patients had a median followup of 11 years and 7 months. Younger age and history of psychosis at the time of classification were associated with development of incident proteinuria, just as were lymphopenia (HR 1.49, 95% CI 1.08-2.06), anti-dsDNA (HR 1.38, 95% CI 1.01-1.87), and a high number of autoantibodies (HR 1.26, 95% CI 1.06-1.48).
The risk of incident proteinuria after onset of SLE was increased by the presence of lymphopenia, anti-dsDNA antibodies, psychosis, younger age, and a high number of autoantibodies at onset.
在一项纵向队列研究中，我们研究了系统性红斑狼疮（SLE）分类时的临床和血清学表现是否可预测随后发生蛋白尿作为狼疮肾炎事件的生物标志物。
纳入了在分类前或分类时没有蛋白尿但符合 SLE 分类标准的患者。在临床就诊时收集了 SLE 表现、生存状态、与标准相关的自身抗体以及与 SLE 相关的药物的数据，并通过病历回顾进行了补充。通过 Cox 回归分析计算 HR。
在 850 例 SLE 患者中，有 604 例在 SLE 分类时没有发生蛋白尿。在这 604 例患者中，有 184 例（30%）在 SLE 分类后发生了蛋白尿。患者的中位随访时间为 11 年 7 个月。分类时年龄较小和精神病史与发生蛋白尿有关，淋巴细胞减少症（HR 1.49，95%CI 1.08-2.06）、抗 dsDNA（HR 1.38，95%CI 1.01-1.87）和大量自身抗体（HR 1.26，95%CI 1.06-1.48）也是如此。
SLE 发病时存在淋巴细胞减少症、抗 dsDNA 抗体、精神病史、年龄较小和大量自身抗体可增加发生蛋白尿的风险。
